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PENNSYLVANIA TO EXPAND MEDICAID — IN ITS OWN WAY — Gov. Tom Corbett announced yesterday that his state will accept billions of Obamacare dollars — but he’s not calling it Medicaid expansion. Under his plan, the federal government would first have to approve a set of reforms to the program, like requiring job training for unemployed recipients and paring back some benefits.

--Rep. Allyson Schwartz, who’s challenging Corbett for his seat next year, had this to say: “He has chosen a path of politically motivated delays and inaction hurting nearly 500,000 working Pennsylvanians who need affordable coverage and now won’t be eligible under his proposal at the earliest until January of 2015.”

Good Tuesday morning on a week that started out very sadly. Our prayers go out for the victims of yesterday’s shootings and their loved ones.

“I’ll shout and I’ll scream, but I’d rather not have seen. And I’ll PULSE away for another day.”

CR + DEBT CEILING = REPUBLICANS WIN? — House GOP leaders are mulling over a new strategy: linking a CR that defunds Obamacare to a debt ceiling hike that delays the health care law in one big, huge, massive attempt to negotiate with Democrats. Maybe that would help them persuade conservatives to go along, avoid a politically disastrous government shutdown, shift the onus onto Obama on hiking the debt ceiling and maximize their own leverage. Or so they hope. Your daily play-by-play: http://politi.co/198ahwF

WOMEN OVERESTIMATE CANCER RISK — Contralateral prophylactic mastectomies — where only one breast has cancer but both are still removed — don’t seem to improve survival rates. But more young women are opting for the double mastectomy anyway, because they overestimate their actual risk for cancer in the unaffected breast. A group of researchers took a closer look at why, in a study published yesterday in the Annals of Internal Medicine. http://politico.pro/1ekdK1b

** Pfizer Helpful Answers is a family of prescription assistance programs that provides eligible patients with their Pfizer prescriptions for free or at a savings, and offers reimbursement support services for select products. www.PHAHelps.com **

VITTER AND BOXER BREAK UP — Congressional divorce is the best metaphor we can think of to describe what’s going on between Sens. Barbara Boxer and David Vitter. The two shared an unlikely legislative romance earlier this year — guiding a water bill through the Senate together — but that’s over now thanks to their complex Obamacare-themed battle. It all started when Vitter tried to ban federal contributions to Hill health plans in an energy bill. POLITICO chronicles it here: http://politico.pro/17EZDOW

--Speaking of Vitter and his amendment, the CBO scored it yesterday as saving nearly $2 billion over 10 years. The score: http://1.usa.gov/1aP0voT

GET READY FOR QUESTIONS ABOUT YOUR SEX LIFE…But don’t doctors already ask about that? Betsy McCaughey, who helped create the phrase “death panel,” writes in the New York Post that patients will have to answer “inappropriate” questions about their sex lives, thanks for the law. The Incidental Economist countered with a blog post arguing that the law won’t require doctors to ask patients any such questions that they’re not already asking. McCaughey’s piece: http://bit.ly/16c9bOx And the IE blog post: http://bit.ly/196HF72

WILL BOEHNER NEED THE D’S? — Pelosi and her members are a bit, er, irrelevant in big spending showdowns since House Republicans typically have enough votes to pass stuff without them. But if conservatives keep bucking Boehner’s directives, he might have to turn to Democrats for help. Of course, to do that he’d have to abandon any idea of defunding the ACA. The POLITICO story: http://politico.pro/18t2i18

AHIP, OTHERS FORM GROUP TO FIGHT HIT — Trade groups are coalescing to fight the new health insurance tax due to take effect in January, dubbing themselves the “Affordable Coverage Project.” Members include the U.S. Chamber of Commerce, the National Retail Federation and America’s Health Insurance Plans. The group began running online ads in August. The release: http://politico.pro/187q1jj

WAXMAN REQUESTS E-CIGARETTE REGS — Energy and Commerce ranking member Henry Waxman and other Democrats wrote to the FDA yesterday, asking Commissioner Margaret Hamburg to regulate e-cigarettes. Their request is in response to a recent CDC report showing that more adolescents are smoking them. The letter: http://1.usa.gov/198Yu12 The Democrats also asked Chairman Fred Upton to hold a hearing on how e-cigarettes can harm public health.

YAY FOR NEW DELIVERY MODELS — It’s not just the recession that has slowed down health care cost growth — new models of delivering care are responsible, too, write Helen Darling, president of the National Business Group on Health, and Susan DeVore, president and CEO of the Premier healthcare alliance. Their POLITICO op-ed:http://politi.co/16r8qEp

CDC RANKS ANTIBIOTIC-RESISTANT GERMS — The CDC has compiled its first-ever snapshot of the antibiotic-resistant germs that kill at least 23,000 people each year. The agency has also ranked the germs into categories of urgent, serious and concerning. The release: http://1.usa.gov/1gp6ldO

BINGE DRINKING COMMON AMONG HIGH SCHOOL SENIORS – Downing five or more alcoholic drinks in a row is common among high school seniors, according to a study published Monday in the Journal of the American Medical Association. Researchers found that 20.2 percent of seniors reported binge drinking (five or more drinks in a row) in the past two weeks, 10.5 percent reported consuming 10 or more drinks and 5.6 percent reported consuming 15 or more drinks. http://bit.ly/15z6Nok

TOMORROW: We’re excited to announce our newest policy area, Pro Education, launches tomorrow and will feature original reporting, breaking news and insight into education policy. Starting tomorrow, paid subscribers to Pro Education will continue to receive Morning Education between 5:30 and 6:00 a.m. Non-subscribers to Pro Education will receive an abridged version of Morning Education at 9:00 am. To learn more about Pro Education, e-mailinfo@politicopro.com or call (703) 341-4600.

WHAT WE’RE READING

As Farzad Mostashari prepares to exit his role as national coordinator for health IT, he reflects on his work over the last four years for iHealthBeat. http://bit.ly/1eW1jYc

Some news outlets have reported that Emory Healthcare — Georgia’s largest hospital system — is laying off workers due to the Affordable Care Act, but that’s just plain not true, the Atlantic writes. http://bit.ly/197ectL

The Texas Tribune reviewed state inspection records for 36 abortion clinics and found little evidence that they were endangering patients, as advocates for the 20-week abortion ban had suggested. The Tribune story, in conjunction with KHN: http://bit.ly/197n7tM

A new poll from USA Today and the Pew Research Center finds that nearly four in 10 uninsured Americans don’t realize the Affordable Care Act requires them to get health insurance next year. http://on.wzzm.com/1669HDx

** A message from Pfizer Helpful Answers: For more than 25 years, Pfizer has been a trusted resource for patients by providing prescription assistance to millions of Americans in need. In the last five years (2008-2012), Pfizer Helpful Answers helped more than 3.4 million uninsured and underinsured patients get access to more than 39 million Pfizer prescriptions, equaling more than $6.5 billion. As health care evolves in 2013 and beyond, Pfizer will continue to adapt the program to meet the changing needs of patients.

Pfizer Helpful Answers is a joint program of Pfizer Inc and the Pfizer Patient Assistance Foundation™. **